Cardiomyopathy

Cardiomyopathy is a general term for diseases of the heart muscle, where the walls of the heart chambers have become stretched, thickened or stiff. This affects the heart's ability to pump blood around the body.

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Restrictive cardiomyopathy

Restrictive cardiomyopathy is rare. It's most often diagnosed in children, although it can develop at any age. The walls of the main heart chambers become stiff and rigid and cannot relax properly after contracting. This means the heart cannot fill up properly with blood.

It results in reduced blood flow from the heart and can lead to symptoms of heart failure, such as breathlessness, tiredness and ankle swelling, as well as heart rhythm problems.

In many cases the cause is unknown, although sometimes the condition can be inherited.

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Arrhythmogenic right ventricular cardiomyopathy

In arrhythmogenic right ventricular cardiomyopathy (ARVC), the proteins that usually hold the heart muscle cells together are abnormal. Muscle cells can die and the dead muscle tissue is replaced with fatty and fibrous scar tissue.

The walls of the main heart chambers become thin and stretched and cannot pump blood around the body properly.

People with ARVC usually have heart rhythm problems. Reduced blood flow from the heart can also lead to symptoms of heart failure.

ARVC is an inherited condition caused by a change (mutation) in one or more genes. It can affect teenagers or young adults and has been the reason for some sudden unexplained deaths in young athletes.

There's increasing evidence that prolonged, strenuous exercise makes the symptoms of ARVC worse. It's important that people with or at risk of ARVC discuss this in detail with their heart specialist (cardiologist).

Diagnosing cardiomyopathy

a detailed family tree drawn by specialists may be required for the diagnosis of a cardiomyopathy

If you've been diagnosed with an inherited type of cardiomyopathy, you may be advised to have a genetic test to identify the faulty gene (mutation) that caused this.

Your relatives can then be tested for the same mutation and, if they have it, their condition can be monitored and managed early.

Treating cardiomyopathy

There's usually no cure for cardiomyopathy, but the treatments can be effective at controlling symptoms and preventing complications. Some types of cardiomyopathy have specific treatments and early diagnosis is very important.

Not everyone with cardiomyopathy will need treatment. Some people only have a mild form of the condition they can control after making a few lifestyle changes.

Lifestyle changes

Whether the cause of cardiomyopathy is genetic or not, it should generally help to:

Hospital procedures

In some people with obstructive hypertrophic cardiomyopathy, the wall dividing the left and right side of the heart (septum) is thickened and bulges into the main heart chamber. They may need to have either:

an injection of alcohol into their heart – this is to reduce part of the muscle in the septum

a septal myectomy – heart surgery to remove part of the thickened septum (the mitral valve may be repaired at the same time, if necessary)

Those with heart rhythm problems may need to have arrhythmia ablation. This treatment carefully alters the diseased heart tissue that causes the heart rhythm problems.

Broken heart syndrome

Some people who experience significant emotional or physical stress, such as bereavement or major surgery, go on to experience a temporary heart problem.

The heart muscle becomes suddenly weakened or "stunned", causing the left ventricle (one of the heart's main chambers) to change shape. It may be caused by a surge of hormones, particularly adrenaline, during a period of stress.

The main symptoms are chest pain and breathlessness, similar to those of a heart attack. Always call 999 if you or someone else experiences these.

The condition – known medically as Takotsubo cardiomyopathy, or acute stress cardiomyopathy – is more common in women. It's temporary and reversible. It's unusual for it to happen again.